Provider Demographics
NPI:1720127590
Name:COX, WILLIAM T (BCO)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:T
Last Name:COX
Suffix:
Gender:M
Credentials:BCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 S MAIN ST
Mailing Address - Street 2:SUITE B6
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-1974
Mailing Address - Country:US
Mailing Address - Phone:770-667-1166
Mailing Address - Fax:770-667-1188
Practice Address - Street 1:401 S MAIN ST
Practice Address - Street 2:SUITE B6
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-1974
Practice Address - Country:US
Practice Address - Phone:770-667-1166
Practice Address - Fax:770-667-1188
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00062048AMedicaid
GA00062048AMedicaid